Omar Nassar, manager of the Richmond Food Center, says he will probably lose business if the soda tax passes.

Omar Nassar, manager of the Richmond Food Center, says he will probably lose business if the soda tax passes.

Photo: Brant Ward, The Chronicle

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On September 29, 2012 in Richmond, Calif. Dr. Jeff Ritterman walks along the trails of Nichole Nob Hill over looking Richmond and the East Bay. He regularly hikes and tries to keep active. Dr. Jeff Ritterman is a city councilman and retired Richmond cardiologist. He is currently spearheading Richmond's controversial soda tax on the November ballot.

On September 29, 2012 in Richmond, Calif. Dr. Jeff Ritterman walks along the trails of Nichole Nob Hill over looking Richmond and the East Bay. He regularly hikes and tries to keep active. Dr. Jeff Ritterman is

Juan Cerritos, who works at Val Mar Market in Richmond, Calif. drinks at least four sodas a day. He is definitely not voting for the new tax. The Richmond City Council has approved a measure for the November ballot which would ask voters to approve a tax on soda and sugary drinks, the first such tax in the nation. less

Juan Cerritos, who works at Val Mar Market in Richmond, Calif. drinks at least four sodas a day. He is definitely not voting for the new tax. The Richmond City Council has approved a measure for the November ... more

Photo: Brant Ward, The Chronicle

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A stack of sodas at a Safeway in San Francisco, California, on Thursday, June 21, 2012. San Francisco mayor Ed Lee declared this summer to be "soda-free" this week.

A stack of sodas at a Safeway in San Francisco, California, on Thursday, June 21, 2012. San Francisco mayor Ed Lee declared this summer to be "soda-free" this week.

Photo: Liz Hafalia, The Chronicle

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Richmond's soda tax campaigner

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The perfect human diet, according to Dr. Jeff Ritterman: Kale. Salad. Tap water. Mercury-free fish. If you insist on eating grains, make it bulgur.

No white flour. No sugar. And absolutely, positively, no soda.

"We all grew up thinking soda could be part of a healthy diet. It's not. Soda is the No. 1 cause of the health crisis in America," Ritterman said. "When we pick up a can of Coke, we're drinking something that is directly linked to obesity, diabetes, heart attacks, cancer, strokes."

Ritterman, 64, has taken his war on soda from his kitchen table to Richmond's November ballot. The Richmond city councilman and retired cardiologist is the force behind the Contra Costa County city's proposed soda tax, a penny-per-ounce surcharge on sugar-sweetened beverages that would raise $3 million a year to fight childhood obesity.

Measure N, the first soda tax in the country to appear on a ballot, would apply to hundreds of beverages, from Coke to apple juice to chocolate milk.

Business license fee

The tax is actually a business license fee that requires business owners to pay the city a penny for every ounce of soda, juice or other sugar-sweetened beverage they sell. Kids running lemonade stands would be exempt, as would churches and nonprofit groups. Diet sodas and baby formula also would be exempt.

The problem with Measure N, according to opponents, is that merchants are likely to spread the added cost to all products, not just soda, to keep prices down and discourage shoppers from driving to nearby cities for their soda fix.

But Ritterman hopes the tax will raise the public's awareness of the health risks associated with sugared drinks and make people think twice before buying their next six-pack of Pepsi.

It has definitely made the beverage industry think twice. Soda and juice companies have so far spent more than $2 million to defeat Measure N, compared with the $30,000 or so raised by the Yes on N camp.

Those millions of dollars have paid for commercial billboards on Richmond streets that urge residents to defeat the measure, glossy mailers that tell voters the tax would hurt small businesses, and political consultants and spokespeople, including Chuck Finnie, a San Francisco spokesman for the American Beverage Association.

"There's no doubt America has a weight problem," Finnie says. "It's the result of lifestyle - exercise, what we eat. Sodas are only a part of that. Healthy outcomes are generally associated with access to quality health care and quality foods. This measure doesn't do that."

Another problem with the measure, Finnie said, is that it does not have an oversight committee or an expiration date. The money goes into the city's general fund for the City Council to allocate.

Red-wagon campaign

Ritterman says, however, that if the measure is successful - and Richmond shoppers stop buying soda at stores and stop drinking soda at restaurants - the measure would generate nothing for the city.

Ritterman's campaign consists largely of him walking around town and talking about the dangers of sugared beverages while pulling a red Radio Flyer wagon loaded with 40 pounds of sugar - the amount he says the average Richmond child drinks in a year. He also circulates video clips on childhood obesity and the threat of "big soda." His campaign mailers are homemade postcards, as opposed to the slick glossy pamphlets of the opposition.

Ritterman decided to pursue a local soda tax last spring, after reading yet another study linking soda to obesity and after seeing hundreds of overweight patients during his 30-year career as a cardiologist at Kaiser Richmond. The evidence is overwhelming, he said.

Soda crackdowns are not new. Cities and states throughout the country have been passing laws regulating soda for the past few years. The most high-profile is the Big Gulp ban in New York City, which prohibits the sale of any soda larger than 16 ounces.

Sugar consumption grows

The number of overweight and obese Americans has more than doubled since 1976, mirroring a steady rise in sugar consumption, according to the Centers for Disease Control and Prevention. Soda is the primary culprit: About a third of all the sugar Americans consume comes from soda, the CDC says.

Since 2002, children have been drinking more soda than milk, according to the New England Journal of Medicine. The average child in Richmond drinks two cans of soda per day, containing a total of about 20 packets of sugar, Ritterman said.

The sugar that comes from soda is particularly dangerous because it enters the bloodstream immediately, quickly converting to fat, instead of going through the digestive process, Ritterman said. Even Skittles are better for you than soda, he said.

In short, soda is slowly killing Richmond's kids, he said. They might not suffer heart attacks at age 15, but they might by age 40, he said.

"We kept waiting for something to happen on the state or federal level, but it hasn't," he said. "That left us with the option: Do we look out for our own children, or do we turn away and say we don't care if these kids are going to die young?"

Ritterman, a native New Yorker who wears his hair in a neat ponytail, has lived in Oakland and most recently Richmond the past 30 years. He has a daughter and a son, Dr. Miranda Weintraub, an epidemiologist at UC Berkeley, and Judah Ritterman, a Berkeley musician and songwriter, and a 14-month-old granddaughter.

For the most part, he practices what he preaches. He eats mostly vegetables, chicken and fish, exercises daily near his Point Richmond home and avoids sugar and flour. During a recent morning meeting at his office, he stuck to water while everyone else drank coffee.

'We have an obligation'

Ritterman is not daunted by the wrath of Coke and Pepsi. He's retired from his medical career and does not plan to run for re-election to the City Council, so he feels he has nothing to lose.

If anything, he's energized. After the Richmond City Council voted to put the tax on the ballot in May, El Monte in Southern California followed suit.

"It's like being the first ones to say cigarettes cause cancer," he said. "It's a challenge, but if we pass this, if we can start to reverse the childhood obesity epidemic, we will be nationally known. ... We have an obligation morally to do this."